MIDDLESEX PLASTIC SURGERY CENTERLLC NPI 1174801898

NPI Information

  • NPI: 1174801898
  • Provider Name: MIDDLESEX PLASTIC SURGERY CENTER,LLC
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Organization
  • Address: 535 SAYBROOK RD
    MIDDLETOWN, CT
    ZIP 06457
  • Phone: (860) 343-0122

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NPI Details

MIDDLESEX PLASTIC SURGERY CENTER,LLC is a plastic surgery in Middletown, CT. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. MIDDLESEX PLASTIC SURGERY CENTER,LLC NPI is 1174801898. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

535 SAYBROOK RD
MIDDLETOWN, CT
ZIP 06457-743
Phone: (860) 343-0122
Fax: (860) 347-2212

The provider's authorized official is Mari Rebane-mazzotta .
The authorized official title is Physician/owner and has the following contact phone number (860) 343-0122.

The enumeration date for this NPI number is 7/29/2011 and was last updated on 7/29/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery049437CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1049437OTHERCONNECTICUTOWNER OPERATOR LIC #

What is NPI?

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This page was last updated on: 11/21/2025

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